Design and development of a simulation model for critical moments of vaginal hysterectomy for surgical training.

Abstract

The route of choice for hysterectomy should be the vaginal route if there is no contraindication. Worldwide, in Gynecology and Obstetrics postgraduate residencies, adequate training and competence for it is not acquired due to the low number of cases. Objective: to design and develop a low-fidelity box simulation model for critical moments of vaginal hysterectomy for surgical training, which helps improve the training of gynecologists - obstetricians who were studying an extension program in the Gynecology and Obstetrics Service in the La Trinidad Middle Teaching Center, in the period February - November 2023. Methodology: three relevant moments of the Vaginal Hysterectomy Technique were identified, low-cost and easy-to-reproduce materials were used to create the model and then its usefulness was validated. Results: the pre-simulation survey requires the need to incorporate simulation in vaginal hysterectomy. In the simulation, it was observed that even though the participants knew the procedure to follow, 66.7% occasionally caused involuntary tissue damage, used efficient timing with some unnecessary movements, as well as repeatedly made hesitant or clumsy movements. Due to the inappropriate use of instruments, in the post-simulation survey the participants felt satisfied with it and found the model realistic. Conclusion: The low-cost simulation model is an advantageous tool with potential for the development of psychomotor skills and abilities in the vaginal hysterectomy technique.